Science and Technology : DRUG RESISTANT TB ON RISE

Kemetstry

going above and beyond
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'Alarming' Rise Seen in Drug-Resistant Tuberculosis


International study found TB withstanding multiple types of antibiotics
By -- Robert Preidt

THURSDAY, Aug. 30 (HealthDay News) -- There are alarmingly high levels of extensively drug-resistant tuberculosis in many areas of the world, a new study finds.
Researchers found high rates of resistance to at least one second-line drug (nearly 44 percent) among multidrug-resistant TB patients in eight countries in Africa, Asia, Europe and Latin America. They also found higher-than-expected overall levels of extensively drug-resistant TB.
Multidrug-resistant TB can withstand to at least two first-line drugs: soniazid and rifampicin. Extensively drug-resistant TB is resistant to isoniazid, rifampicin, a fluoroquinolone and a second-line injectable drug.
Fluoroquinolones are a class of antibiotics that include ciprofloxacin, levofloxacin and gatifloxacin.
For the study, samples collected from nearly 1,300 adults with multidrug-resistant TB in Estonia, Latvia, Peru, the Philippines, Russia, South Africa, South Korea and Thailand were tested for resistance to 11 first-line and second-line anti-TB drugs. Overall, in nearly 44 percent of patients, resistance to any second-line drug was detected. Rates ranged from 33 percent in Thailand to 62 percent in Latvia.
Overall, one-fifth of patients had resistance to at least one second-line injectable drug, ranging from 2 percent in the Philippines to 47 percent in Latvia. The overall rate of resistance to a fluoroquinolone was nearly 13 percent, ranging from 7 percent in the Philippines to 32 percent in South Korea.
Extensively drug-resistant TB was found in 6.7 percent of patients overall, with prevalence in South Korea (15 percent) and Russia (11 percent) more than twice the current World Health Organization estimate for the same time period (5.4 percent).
The researchers also found that the risk of extensively drug-resistant TB was more than four times higher in patients previously treated for TB, and that previous treatment with second-line drugs was the strongest risk factor for resistance.
The study was published online Aug. 29 in The Lancet.
"Drug-resistant TB is more difficult and costly to treat, and more often fatal. Internationally, it is particularly worrisome in areas with fewer resources and less access to effective therapies. As more individuals are diagnosed with, and treated for, drug-resistant TB, more resistance to second-line drugs is expected to emerge," lead author Tracy Dalton, of the U.S. Centers for Disease Control and Prevention, said in a journal news release.
"So far, [extensively drug-resistant] TB has been reported in 77 countries worldwide, but exact prevalence remains unclear," Dalton noted.
"Most international recommendations for TB control have been developed for [multidrug-resistant] TB prevalence of up to around 5 percent. Yet now we face prevalence up to 10 times higher in some places, where almost half of the patients with infectious disease are transmitting [multidrug-resistant] strains," Sven Hoffner, from the Swedish Institute for Communicable Disease Control, wrote in an accompanying journal editorial.
"Updated information on [multidrug-resistant] TB and investigation of the trends are urgently needed...especially since the true scale of the burden of [multidrug-resistant] and [extensively drug-resistant tuberculosis] might be underestimated and seem to be rapidly increasing," he wrote.
More information
The U.S. Centers for Disease Control and Prevention has more about TB.
SOURCE: The Lancet, news release, Aug. 29, 2012
 

MimiBelle

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It's getting 'icky' out there...

*sigh*
This is no surprise but just knowing the amt of time and money that it's gonna take to create a 'something' to contend with this, makes me nauseous.

I was exposed to TB last year while doing volunteer work along the border. Had my annual TB done some weeks after and there it was: INFLAMMATION.
That's one of the negatives of 'community health'. *laugh*
Y'know - I really don't even recall being sneezed or coughed on.
But that's the thing with 'droplets', I suppose. They're small and 'airborne'.

Wash your hands and cover your mouths when you sneeze/cough.
That's a good way to remain infection free.
Compliance, as always, is a major problem. If the sickly took their ENTIRE series of antitubecular meds for the prescribed period of time? We wouldnt be fighting off stronger and stronger strains, in the first place.

Bad enough that we have the 'ick' that is MRSA (among other HAIs) in the hospitals (namely).
You can blame that on the medical personnel, though.
Sanitizer is a good thing, but it tends to make viruses more virulet....and you sometimes can't leave people with alternatives like that. They dont know to use it wisely.
You, for instance, shouldn't use sanitizers in place of handwashing when you've taken care of a pt with C-Diff infected BM...because sanitizer doesn't kill things like Cdiff (or TB spores, for that matter).
If that's the case, you kind of have to wonder why hand sanitizer dispensers are over the walls of most medical facilities in the first place.
Sanitizer is good...but if the goal is prevention?

At one of my PRN gigs, there was an LVN and one aide who showed up to work with some acrylics! Infection control...hello?
They weren't even french or something faux natural.
The nurse - this hag actually came in with these long, pink 'ghetto-nail' acrylics with charms and crap all over it.
I told her in so many words to either hack that s--t off or go home.
I was waiting for her to catch an attitude.
I didn't give a crap that she 'just got 'em done'. She wasn't supposed to have them on to begin with!
*laugh*

Don't you just hate people who test boundaries? Ugh, when I first came on we had this med aide who'd run around in her cheek piercings.
I made her take that s--t out, too.
It's tacky. Besides the fact that it's unprofessional and a 'bad look' for the facility?
Imagine your grandmother/father with this in their face all day:

"Can you please remove your face boogers? You're scaring the residents..."
*laugh*
I freakin' HATE when people do things knowing good and well that they've no business engaging in...then turn around and get mad because someone corrects them.

No acrylics. No chipped nail polish...because they're a reservoir o' disease. Not fitting for those providing direct pt care.

Now, them's the rules, per CDC and nursing standards.

But...y'know -- some of the w/end staff just come in and try their best to skirt the rules simply b/c the DON/ADON and such aren't there.
I just cringe thinking of all the squirmy little microbes beneath her nails. Yuck.
 

Kemetstry

going above and beyond
PREMIUM MEMBER
Feb 19, 2001
28,226
8,057
Detroit
Occupation
Chemist
It's getting 'icky' out there...

*sigh*
This is no surprise but just knowing the amt of time and money that it's gonna take to create a 'something' to contend with this, makes me nauseous.

I was exposed to TB last year while doing volunteer work along the border. Had my annual TB done some weeks after and there it was: INFLAMMATION.
That's one of the negatives of 'community health'. *laugh*
Y'know - I really don't even recall being sneezed or coughed on.
But that's the thing with 'droplets', I suppose. They're small and 'airborne'.

Wash your hands and cover your mouths when you sneeze/cough.
That's a good way to remain infection free.
Compliance, as always, is a major problem. If the sickly took their ENTIRE series of antitubecular meds for the prescribed period of time? We wouldnt be fighting off stronger and stronger strains, in the first place.

Bad enough that we have the 'ick' that is MRSA (among other HAIs) in the hospitals (namely).
You can blame that on the medical personnel, though.
Sanitizer is a good thing, but it tends to make viruses more virulet....and you sometimes can't leave people with alternatives like that. They dont know to use it wisely.
You, for instance, shouldn't use sanitizers in place of handwashing when you've taken care of a pt with C-Diff infected BM...because sanitizer doesn't kill things like Cdiff (or TB spores, for that matter).
If that's the case, you kind of have to wonder why hand sanitizer dispensers are over the walls of most medical facilities in the first place.
Sanitizer is good...but if the goal is prevention?

At one of my PRN gigs, there was an LVN and one aide who showed up to work with some acrylics! Infection control...hello?
They weren't even french or something faux natural.
The nurse - this hag actually came in with these long, pink 'ghetto-nail' acrylics with charms and crap all over it.
I told her in so many words to either hack that s--t off or go home.
I was waiting for her to catch an attitude.
I didn't give a crap that she 'just got 'em done'. She wasn't supposed to have them on to begin with!
*laugh*

Don't you just hate people who test boundaries? Ugh, when I first came on we had this med aide who'd run around in her cheek piercings.
I made her take that s--t out, too.
It's tacky. Besides the fact that it's unprofessional and a 'bad look' for the facility?
Imagine your grandmother/father with this in their face all day:

"Can you please remove your face boogers? You're scaring the residents..."
*laugh*
I freakin' HATE when people do things knowing good and well that they've no business engaging in...then turn around and get mad because someone corrects them.

No acrylics. No chipped nail polish...because they're a reservoir o' disease. Not fitting for those providing direct pt care.

Now, them's the rules, per CDC and nursing standards.

But...y'know -- some of the w/end staff just come in and try their best to skirt the rules simply b/c the DON/ADON and such aren't there.
I just cringe thinking of all the squirmy little microbes beneath her nails. Yuck.



The real issue with TB is the bacteria is a sporeophore. That's what took so long to find the 1st cure. I submit we will see a lot of old plagues coming back to haunt us real soon






..
 

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